National Provider Identifier [NPI]: |
1942494018 |
Last Name Of The Provider |
SHRESTHA |
First Name Of The Provider |
SANTOSH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
901 W JEFFERSON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
627024833 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
1190 |
Number Of Medicare Beneficiaries |
267 |
Total Submitted Charge Amount |
162240 |
Total Medicare Allowed Amount |
69252.69 |
Total Medicare Payment Amount |
51832.85 |
Total Medicare Standardized Payment Amount |
50946.51 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
15 |
Number Of Medical Services |
1190 |
Number Of Medicare Beneficiaries With Medical Services |
267 |
Total Medical Submitted Charge Amount |
162240 |
Total Medical Medicare Allowed Amount |
69252.69 |
Total Medical Medicare Payment Amount |
51832.85 |
Total Medical Medicare Standardized Payment Amount |
50946.51 |
Average Age Of Beneficiaries |
59 |
Number Of Beneficiaries Age Less65 |
160 |
Number Of Beneficiaries Age 65 to 74 |
55 |
Number Of Beneficiaries Age 75 to 84 |
36 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
141 |
Number Of Male Beneficiaries |
126 |
Number Of Non Hispanic White Beneficiaries |
251 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
102 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
165 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
46 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.3566 |